Archived: Oakwell

Updated 26 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

An adult social care inspector completed this unannounced inspection on 18 and 25 April 2018. It was completed on 25 May 2018, after we had spent two days contacting all the relatives and four professionals who are involved in working with people who use the service.

Before the inspection, we used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. This was sent in by the provider. We reviewed this document and other information we held about the service as part of our inspection. This included the notifications we had received from the provider. Notifications are reports about changes, events or incidents the provider is legally obliged to send CQC within required timescales.

During the inspection we spoke with six people who used the service, the registered manager, the clinical lead, three nurses and three support workers. We looked at three care plans and medicine administration records (MARs). We also looked at two staff files, which included recruitment records and the records related to the overall management of the service.

Updated 26 July 2018

The inspection took place on 18, 25 April and the inspection was completed on 25 May 2018. This was an unannounced inspection which meant people did not know that we would be visiting.

We last inspected the service on 10 and 12 February 2016 and found the provider was meeting the fundamental standards of relevant regulations. We rated Oakwell as ‘good.’

Oakwell is a ‘care home.’ People in care homes receive accommodation and nursing care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Oakwell can accommodate up to 13 people in one building and provides care for people who experience mental health conditions. At the time of the inspection eight people were in receipt of care from the service.

The registered manager had been in post for over two years and became registered with CQC in December 2016. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. They are also the registered manager for a sister home Coalway Lane and spends half a day in each service every day during the week.

We found the provider had instilled a positive culture within the service which meant people were given every opportunity and were supported through challenging situations. The provider aimed to go the extra mile and never give up, we saw copious amounts of evidence confirming this was the case. Staff were making a difference to people’s wellbeing by working well as a team, in harmony with one another and by sharing the same values and principles. We found that staff tirelessly worked to engage people in recovery programmes and would continue to support people even when they wanted to lead chaotic lifestyles. For instance, one person was reluctant to engage with the service or address their difficulties and although they were not willing to stay at the service staff regularly spoke with them, offered access to facilities so they could attend to their personal care and worked with other professionals to complete welfare checks.

Staff were totally committed to delivering a service which improved the lives of the people who use the service in fulfilling and creative ways. Their drive and passion had created an exceptionally dynamic and vibrant service. Staff focused fully on the goals and aspirations of the people who used it. People told us the service provided care and support that was exceptional. They discussed how staff had supported them to redevelop skills and learn techniques that would reduce the negative impact their mental health conditions may cause. People also told us that the staff had enabled them to rebuild their relationships with family members and this meant a great deal to them.

Staff worked collaboratively with people to assist them to ensure their voices were heard by healthcare professionals. The service was providing treatment on par with that seen in rehabilitation hospital services and people who were receiving treatment on acute mental health wards were referred by their treating team to Oakwell. There were sufficient staff on duty to meet the needs of the people and the staff team were very supportive of the registered manager, the providers and of each other. The staff team comprised of eight registered mental health nurses and six support workers. All the staff had received in-depth training around working with people who lived with mental health conditions.

Staff were exceptionally caring and understood how to support and enable individuals to maximise their potential. The service was proactive in providing people with a range of information to assist them to make decisions about their health and wellbeing. People were supported to develop their independent living skills. Staff took on dedicated roles for sourcing and setting up both activities people could do at the service and in the community. They actively supported people to engage in community activities and seek meaningful occupation. Some of the people told us how staff had actively supported them to find employment opportunities. Other people told us how staff had worked with them to enhance their independent living skills, which had led to them moving to less supported accommodation. People were exceptionally complimentary about the staff.

The service's visions and values promoted people's rights to make choices and live a dignified and fulfilled life. This was reflected in the care and support that people received. People were supported to be as independent as possible and could access advocacy services if needed. Procedures were in place to investigate and respond to complaints.

We saw people’s care plans were person centred and had been well assessed. People’s care needs were risk assessed with risk management plans in place and support for staff when they needed it. We found staff ensured the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) requirements were met. We also found that staff ensured the Mental Health Act 1983 (amended 2007) code of practice was followed.

We saw that staff were recruited safely and were given appropriate training before they commenced employment. Staff told us they received regular supervision and annual appraisals. Staff were respected within the organisation and were provided with a comprehensive range of training. We found staff were consistently striving for excellence and the provider supported them to achieve this goal by assisting staff to attend specialist training around working with people who lived with mental health conditions.

Medicines were stored and administered in a safe manner and staff were appropriately trained.

The registered manager had encouraged staff to constantly think about improvements. We found that the management style had led to people who used the service and staff feeling that they were integral and essential partners in the operation of the service. They constantly critically reviewed the quality of the service and routinely identified how they could enhance the service and ensure the staff remained at the forefront of best practice when working with the people who used the service. Their oversight of the service and encouragement of staff to keep abreast of developments and be innovative had led to excellent outcomes for the people who used the service and their relatives.

The provider gathered information about the quality of their service from a variety of sources including people who used the service, their family and friends and external agencies. People made the key decisions about who was employed, the service model, the décor and the range of activities.

This was used to enable the provider to identify where improvement was needed and to sustain continuous improvement in the service.

The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken